Abstract 12011: Vascular Function in Leukemia Survivors After Hematopoietic Cell Transplantation
Introduction: Previously, we have documented the effects of radiation and/or chemotherapy on vascular structure and function in childhood cancer survivors. To date, little is known about the effects on vascular health of the hematopoietic cell transplantation (HCT) preparative regimen (total body irradiation [TBI] and high dose chemotherapy) that often accompanies this treatment.
Hypothesis: HCT preparative regimens utilizing TBI would result in a decrement in arterial function in HCT survivors than those that did not utilize TBI.
Methods: Measures of carotid artery stiffness (compliance, distensibility) and intima-media thickness (cIMT) were obtained from ultrasound imaging in patients who had survived >2 years after HCT for hematologic malignancy and were diagnosed at age <21 yrs. Siblings (n=122) were invited to participate as controls. A total of 87 HCT survivors were examined; 50 received TBI only, 17 received TBI plus central nervous system irradiation (TBI+CNS); another 20 received a chemotherapy only preparative regimen ([CHEMO], most busulfan + cyclophosphamide).
Results: Although cIMT did not differ between siblings and HCT survivors, both carotid cross-sectional compliance (CSD) and carotid diameter distensibility (DD) were greater in siblings than HCT survivors (Table). Comparing the different HCT preparative regimens, cIMT did not differ significantly between siblings and the three preparative regimen groups. However, both CSD and DD were significantly lower in TBI+CNS and TBI subjects compared to siblings. Also, carotid incremental elastic modulus (IEM) was significant higher in TBI+CNS than in the TBI only, CHEMO, and sibling groups.
Conclusion: These results demonstrate that HCT preparative regimens containing TBI result in greater arterial decrements indicating increased risk for premature atherosclerosis and cardiovascular disease. The addition of CNS radiation to TBI results in further decrements in arterial function.
Author Disclosures: D.R. Dengel: None. A.S. Kelly: None. L. Zhang: None. J.S. Hodges: None. J. Steinberger: None. K.S. Baker: None.
- © 2015 by American Heart Association, Inc.